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Regional Policy Dialogues in the Caribbean on Chronic Non-Communicable Diseases

Regional Policy Dialogues in the Caribbean on Chronic Non-Communicable Diseases Dr. Rudolph O. Cummings MPH, Program Manager, Health Sector Development, Caricom Secretariat Montreal, May 2008. Regional Situation Mortality and Morbidity. Potential Impact for BP and Cholesterol Control.

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Regional Policy Dialogues in the Caribbean on Chronic Non-Communicable Diseases

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  1. Regional Policy Dialogues in the Caribbean on Chronic Non-Communicable Diseases Dr. Rudolph O. Cummings MPH, Program Manager, Health Sector Development, Caricom Secretariat Montreal, May 2008

  2. Regional SituationMortality and Morbidity

  3. Potential Impact for BP and Cholesterol Control • Barbados: (Hennis et al, 2002) >40 yrs, HBP prevalence = 55% Awareness = 63% Treatment = 54% Control = 19% treatment of those with chronic disease with aspirin and simple drugs to lower blood  pressure and cholesterol (18 million deaths averted  at a cost of $1.10 per year)

  4. POS NCD Declaration Update Report

  5. Achievements – Infrastructure – Secretariat, Plans, M&E (POS #1, 14) • Regional • Summit implementation grant from Public Health Agency Canada: $507,000. (Spend by August 08) • PAHO/OCPC/CARICOM Secretariat • Meets every 2 weeks, CMO’s chair, D/CFNI, D/CAREC • Workplan drafted • Sharepoint site under construction

  6. Monitoring and Evaluation (POS#13,11) • StrengthenCAREC's Behavioural surveillance capacity • PAN AM STEPS NCD risk factor surveys, National NCD Capacity Survey, Global School Health Survey • Training and execution • Data analysis and use to monitor POS Declaration • Decentralization of WHO InfoBase to CAREC • Collaboration with UWI/CAREC on IDB funded surveillance project

  7. Monitoring and Evaluation (POS#13,14) cont’d • Strengthen OCPC coordination capacity – Alafia Samuels on staff from April 1st 2008 • Case study preparation – draft completed • Monitoring and Evaluation • Summit Evaluation Framework used to report - v2 now circulated • Accepted by Heads in March 08 • Process, Output, Indicators, Sources of Data • Web-based reporting on sharepoint site (in process)

  8. Strengthening Country Capacity (POS#2) • NCD Policy capacity building workshop for 10 ECC countries and Barbados, October 2007 • CARMEN meeting in Bahamas Nov 4 – 8, 2007

  9. National NCD Summits (POS # 2) • Dominica’s PM Skerritt convened National NCD Summit in Dominica 14 Dec 2007 • Barbados already has an NCD Commission since January 2007 • Trinidad formulating a “Healthy Lifestyles” initiative • At Heads Inter-sessional March 08, 5 committed to convene NCD Summit • Guyana, Bahamas, Belize, St Vincent and Grenadines and St Kitts/Nevis

  10. Tobacco (POS #3,4) • Countries who still need to ratify • Bahamas • Haiti • St Kitts and Nevis • St. Vincent & Grenadines • Suriname • Letter of Intent to Gates for 5-yr, US$6 million to support Tobacco control in Caribbean, incl. legal support for drafting legislation (POS #3, #4)

  11. Status of CARICOM COUNTRIES

  12. Status of CARICOM COUNTRIES

  13. SUPORTING THE CROSQ PROCESS • Jamaica BoS designated to draft new regulations for packaging and labeling • Draft standard circulated to member states for review and submission of comments • Comments received from some member states • Urgent need to strengthen the standard to meet the FCTC obligations • CARICOM request to PAHO WDC and OCPC to support the process.

  14. Healthy Eating (POS # 6,7,8 9) Ministers of Agriculture of CARICOM, St. Ann Declaration, 9 October 2007 • Implementing Agriculture and Food Policies to prevent Obesity and NCDs in CARICOM • Use Regional and WTO agreements to ensure food security • Support the CRNM to pursue fair trade policies • Policies that explicitly incorporate nutritional goals • Elimination of trans-fats from our food supply using CFNI as a focal point • Labeling of foods to indicate their nutritional content; • Public education for increased consumption of fruits and vegetables • Food Security Plan for prevention and control of NCDs

  15. Active Living, Caribbean Wellness Day 20th Sept 2008 (POS #6,10, 12,15) Policy dialogue on scaling up physical activity, with CDC 6- 7 May 2008 in POS – • To explore options for sustained physical activity • To present options to private sector meeting May 8 - 9 • To plan for CWD 2008 • Countries now have draft national plans

  16. Advantages of Risk Charts • Simplified, clear message and Cue for lay and PHC workers • Reorient perception : practitioners identify total risk • Composite risk score : Process for fast-forwarding those at highest risk • Risk approach/charts will guide intensification of management, and not reduce treatment goals. • Practical for professionals and to patient • Empowering of individuals with the information about their risk, how to reduce risk by moving from top right to bottom left in their age and sex category

  17. Next Steps • CMOs approval in Surinam April 21 for MOH introduction • Considered 4 instead of 5 levels ( green, yellow, orange, red) • Availability of variables in PHC in the Caribbean? Cholesterol testing should be encouraged • Pilot testing, perhaps through IDB Surveillance of DM QOC projects • CHRC to produce “pocket guidelines” summaries of its existing Clinical Guidelines, and review the proposal to integrate with the Risk Charts to produce “Caribbean Cardiovascular Disease Guidelines”

  18. Media and Communications • Media group established and working virtually • Draft plan developed and under discussion • Need to document Health Promotion and NCD Prevention and Control activities and initiatives in countries. • Activities around World Health Day documented for the first time along sustainable transportation • Public and private sharepoint site to share info e.g. TOR from Barbados NCD Commission, program from Dominica NCD Summit

  19. Involvement of Private Sector, Media (POS #12) • CAIC engaged: Private Sector meeting 8-9 May 2008, POS • Hear the business case for Private Sector involvement in NCD prevention and control • Discuss options for interventions (CFNI proposals) • Design a Plan of Action and implementation mechanisms with partners • Workplace Wellness incentive-based awards • Healthy food policies (America’s / CARICOM Pledge) • Media and communications • Support for Caribbean Wellness Day-promote a park and biking and walking days

  20. Next steps • First Caribbean Wellness Day – Sept 13 • Caribbean 10k in July in Antigua • Heads will demonstrate by example of walk to start point • NGO forum in October to be coordinated in Barbados for Health NGOs –Prof. Hassel

  21. THANK YOU

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